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Accurate vessel segmentation in Ultra-Wide-Field Scanning Laser Ophthalmoscopy (UWF-SLO) images is crucial for diagnosing retinal diseases. Although recent techniques have shown encouraging outcomes in vessel segmentation, models trained on one medical dataset often underperform on others due to domain shifts. Meanwhile, manually labeling high-resolution UWF-SLO images is an extremely challenging, time-consuming and expensive task. In response, this study introduces a pioneering framework that leverages a patch-based active domain adaptation approach. By actively recommending a few valuable image patches by the devised Cascade Uncertainty-Predominance (CUP) selection strategy for labeling and model-finetuning, our method significantly improves the accuracy of UWF-SLO vessel segmentation across diverse medical centers. In addition, we annotate and construct the first Multi-center UWF-SLO Vessel Segmentation (MU-VS) dataset to promote this topic research, comprising data from multiple institutions. This dataset serves as a valuable resource for cross-center evaluation, verifying the effectiveness and robustness of our approach. Experimental results demonstrate that our approach surpasses existing domain adaptation and active learning methods, considerably reducing the gap between the Upper and Lower bounds with minimal annotations, highlighting our method's practical clinical value. We will release our dataset and code to facilitate relevant research: https://github.com/whq-xxh/SFADA-UWF-SLO., Comment: MICCAI 2024 Early Accept

Radiation therapy is a primary and effective NasoPharyngeal Carcinoma (NPC) treatment strategy. The precise delineation of Gross Tumor Volumes (GTVs) and Organs-At-Risk (OARs) is crucial in radiation treatment, directly impacting patient prognosis. Previously, the delineation of GTVs and OARs was performed by experienced radiation oncologists. Recently, deep learning has achieved promising results in many medical image segmentation tasks. However, for NPC OARs and GTVs segmentation, few public datasets are available for model development and evaluation. To alleviate this problem, the SegRap2023 challenge was organized in conjunction with MICCAI2023 and presented a large-scale benchmark for OAR and GTV segmentation with 400 Computed Tomography (CT) scans from 200 NPC patients, each with a pair of pre-aligned non-contrast and contrast-enhanced CT scans. The challenge's goal was to segment 45 OARs and 2 GTVs from the paired CT scans. In this paper, we detail the challenge and analyze the solutions of all participants. The average Dice similarity coefficient scores for all submissions ranged from 76.68\% to 86.70\%, and 70.42\% to 73.44\% for OARs and GTVs, respectively. We conclude that the segmentation of large-size OARs is well-addressed, and more efforts are needed for GTVs and small-size or thin-structure OARs. The benchmark will remain publicly available here: https://segrap2023.grand-challenge.org, Comment: A challenge report of SegRap2023 (organized in conjunction with MICCAI2023)

Nasopharyngeal carcinoma (NPC) is a prevalent and clinically significant malignancy that predominantly impacts the head and neck area. Precise delineation of the Gross Tumor Volume (GTV) plays a pivotal role in ensuring effective radiotherapy for NPC. Despite recent methods that have achieved promising results on GTV segmentation, they are still limited by lacking carefully-annotated data and hard-to-access data from multiple hospitals in clinical practice. Although some unsupervised domain adaptation (UDA) has been proposed to alleviate this problem, unconditionally mapping the distribution distorts the underlying structural information, leading to inferior performance. To address this challenge, we devise a novel Sourece-Free Active Domain Adaptation (SFADA) framework to facilitate domain adaptation for the GTV segmentation task. Specifically, we design a dual reference strategy to select domain-invariant and domain-specific representative samples from a specific target domain for annotation and model fine-tuning without relying on source-domain data. Our approach not only ensures data privacy but also reduces the workload for oncologists as it just requires annotating a few representative samples from the target domain and does not need to access the source data. We collect a large-scale clinical dataset comprising 1057 NPC patients from five hospitals to validate our approach. Experimental results show that our method outperforms the UDA methods and achieves comparable results to the fully supervised upper bound, even with few annotations, highlighting the significant medical utility of our approach. In addition, there is no public dataset about multi-center NPC segmentation, we will release code and dataset for future research.

Robot-assisted surgery has made significant progress, with instrument segmentation being a critical factor in surgical intervention quality. It serves as the building block to facilitate surgical robot navigation and surgical education for the next generation of operating intelligence. Although existing methods have achieved accurate instrument segmentation results, they simultaneously generate segmentation masks for all instruments, without the capability to specify a target object and allow an interactive experience. This work explores a new task of Referring Surgical Video Instrument Segmentation (RSVIS), which aims to automatically identify and segment the corresponding surgical instruments based on the given language expression. To achieve this, we devise a novel Video-Instrument Synergistic Network (VIS-Net) to learn both video-level and instrument-level knowledge to boost performance, while previous work only used video-level information. Meanwhile, we design a Graph-based Relation-aware Module (GRM) to model the correlation between multi-modal information (i.e., textual description and video frame) to facilitate the extraction of instrument-level information. We are also the first to produce two RSVIS datasets to promote related research. Our method is verified on these datasets, and experimental results exhibit that the VIS-Net can significantly outperform existing state-of-the-art referring segmentation methods. Our code and our datasets will be released upon the publication of this work.

For robot-assisted surgery, an accurate surgical report reflects clinical operations during surgery and helps document entry tasks, post-operative analysis and follow-up treatment. It is a challenging task due to many complex and diverse interactions between instruments and tissues in the surgical scene. Although existing surgical report generation methods based on deep learning have achieved large success, they often ignore the interactive relation between tissues and instrumental tools, thereby degrading the report generation performance. This paper presents a neural network to boost surgical report generation by explicitly exploring the interactive relation between tissues and surgical instruments. We validate the effectiveness of our method on a widely-used robotic surgery benchmark dataset, and experimental results show that our network can significantly outperform existing state-of-the-art surgical report generation methods (e.g., 7.48% and 5.43% higher for BLEU-1 and ROUGE).